Temporal Trends and Outcomes of Patients Undergoing Percutaneous Coronary Interventions for Cardiogenic Shock in the Setting of Acute Myocardial Infarction

• Published in: JACC. Cardiovascular interventions 2016-02, Vol.9 (4), p.341-351
• Main Authors: Wayangankar, Siddharth A., MD, MPH, Bangalore, Sripal, MD, MHA, McCoy, Lisa A., MS, Jneid, Hani, MD, Latif, Faisal, MD, Karrowni, Wassef, MD, Charitakis, Konstantinos, MD, Feldman, Dmitriy N., MD, Dakik, Habib A., MD, Mauri, Laura, MD, Peterson, Eric D., MD, MPH, Messenger, John, MD, Roe, Mathew, MD, Mukherjee, Debabrata, MD, Klein, Andrew, MD
• Format: Article
• Language: English
• Subjects: acute coronary syndrome(s); acute myocardial infarction; cardiogenic shock; Cardiovascular; percutaneous coronary intervention
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2015.10.039

Abstract Objectives The purpose of this study was to examine the temporal trends in demographics, clinical characteristics, management strategies, and in-hospital outcomes in patients with acute myocardial infarction complicated by cardiogenic shock (CS-AMI) who underwent percutaneous coronary intervention (PCI) from the Cath-PCI Registry (2005 to 2013). Background The authors examined contemporary use and outcomes of PCI in patients with CS-AMI. Methods The authors used the Cath-PCI Registry to evaluate 56,497 patients (January 2005 to December 2013) undergoing PCI for CS-AMI. Temporal trends in clinical variables and outcomes were assessed. Results Compared with cases performed from 2005 to 2006, CS-AMI patients receiving PCI from 2011 to 2013 were more likely to have diabetes, hypertension, dyslipidemia, previous PCI, dialysis, but less likely to have chronic lung disease, peripheral vascular disease, or heart failure within 2 weeks (p < 0.01). Between 2005 and 2006 to 2011 and 2013, intra-aortic balloon pump use decreased (49.5% to 44.9%; p < 0.01), drug-eluting stent use declined (65% to 46%; p < 0.01), and the use of bivalirudin increased (12.6% to 45.6%). Adjusted in-hospital mortality; increased (27.6% in 2005 to 2006 vs. 30.6% in 2011 to 2013, adjusted odds ratio: 1.09, 95% confidence interval: 1.005 to .173; p = 0.04) for patients who were managed with an early invasive strategy (